Journal of Bone and Joint Infection最新文献

{"title":"Clinical characteristics of culture-negative periprosthetic joint infections: findings from an international periprosthetic joint infection registry.","authors":"Graham S Goh, Elise R Naufal, Michelle M Dowsey, Sina Babazadeh, Jesse E Otero, Carlos A Higuera-Rueda, Marjan Wouthuyzen-Bakker","doi":"10.5194/jbji-10-553-2025","DOIUrl":"10.5194/jbji-10-553-2025","url":null,"abstract":"<p><p><b>Background</b>: Culture-negative periprosthetic joint infections (CN-PJIs) remain a major problem in the field of orthopedic infections. The clinical features of CN-PJI and its risk factors remain poorly defined. The purpose of this study was to elucidate the characteristics of CN-PJI. <b>Methods</b>: This was a retrospective multi-center cohort study as part of the Orthopaedic Device Infection Network (ODIN). Using real-world data from five institutions across Australia, the Netherlands and the USA, 563 cases of PJI (470 culture positive, 93 culture negative) were queried between 1995 and 2021. Patients with CN-PJI had negative cultures on pre-operative aspiration, blood or intra-operative cultures. Demographics, history of surgery on the infected joint, presenting symptoms, operative details, laboratory values and intra-operative findings were recorded. Multivariable regression was used to determine the association between these variables and culture negativity. <b>Results</b>: The prevalence of CN-PJI was 16.5 %. Bivariate analysis revealed that patients with CN-PJI were more likely to be female, have a revision arthroplasty or prior PJI, have a longer duration of symptoms and were less likely to present with fever, wound dehiscence or wound necrosis; they also had lower hemoglobin and serum CRP ( <math><mi>p</mi></math> <math><mo><</mo></math> <math><mn>0.05</mn></math> for all). Using multivariable regression, the only factor significantly associated with CN-PJI was a duration of symptoms of <math><mo>></mo></math> 12 weeks (OR 2.24, 95 % CI 1.008-4.964, <math><mi>p</mi></math> <math><mo>=</mo></math> <math><mn>0.048</mn></math> ). <b>Conclusions</b>: Patients with prolonged symptoms were twice as likely to have negative cultures, supporting the traditional belief that CN-PJI presents more insidiously. These clinical data should be used to guide the selection of advanced investigations.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"553-559"},"PeriodicalIF":2.8,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cause of death following revision for periprosthetic joint infection or major aseptic revision in total hip and knee arthroplasty.","authors":"Nicolai Kjældgaard Kristensen, Per Hviid Gundtoft, Brian Elmengaard, Alma Becic Pedersen, Jeppe Lange","doi":"10.5194/jbji-10-543-2025","DOIUrl":"10.5194/jbji-10-543-2025","url":null,"abstract":"<p><p><b>Background and purpose</b>: Periprosthetic joint infection (PJI) revisions for total knee arthroplasty (TKA) and total hip arthroplasty (THA) have increased all-cause mortality. It remains unclear whether specific causes of death contribute to this excess mortality. Our purpose was to compare the underlying causes of death in patients revised for PJI with aseptic failure and to compare THA and TKA causes of death. <b>Methods</b>: We used routinely collected data from Danish health registries. We identified 9078 patients undergoing first-time revision for PJI or aseptic failure in the Danish Hip and Knee Arthroplasty Register. PJI was primarily defined by intra-operative microbiological cultures. The causes of death were obtained from the Cause of Death Register. We used inverse probability of treatment weighting (IPTW) to adjust for confounding and calculated adjusted hazard ratios (aHRs) with a 95 % confidence interval (CI). Among 2755 deceased patients, 37 % had undergone revision for PJI and 63 % for aseptic failure. The PJI group had a higher comorbidity burden and more hip revisions but was similar in age and marital status compared to aseptic revisions. <b>Results</b>: Cancer, circulatory, and respiratory diseases were the most common causes of death in both groups. However, deaths from musculoskeletal diseases (aHR 3.04, 95 % CI: 1.67-5.56), infections (aHR 2.13, 95 % CI: 1.06-4.30), and age-related causes (aHR 2.05, 95 % CI: 1.22-3.45) were more frequent after PJI revision. <b>Conclusion</b>: The increased mortality after PJI revision appears to be multifactorial, involving a range of causes rather than a single dominant driver.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"543-552"},"PeriodicalIF":2.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12750518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of alpha-defensin ELISA and lateral flow assays for periprosthetic joint infection: a systematic review and meta-analysis.","authors":"Benjamin R Paul, David G Deckey, Alex Soriano, Andy Miller, Thorsten M Seyler","doi":"10.5194/jbji-10-525-2025","DOIUrl":"10.5194/jbji-10-525-2025","url":null,"abstract":"<p><p><b>Background</b>: Alpha-defensin (AD) is a synovial biomarker that can be used in the diagnosis of periprosthetic joint infection (PJI). Two testing modalities are available: the laboratory-based enzyme-linked immunosorbent assay (ELISA) and the point-of-care (POC) lateral flow (LF) assay. Although both assays have been incorporated into modern PJI diagnostic algorithms, their comparative diagnostic accuracy remains incompletely defined. <b>Methods</b>: A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane databases were searched from 1 January 2000 to 1 February 2024. Studies using contemporary PJI definitions were included. Eligible studies evaluated the diagnostic performance (sensitivity and specificity) of AD-ELISA or AD-LF in patients undergoing evaluation for suspected PJI. Pooled sensitivity and specificity were calculated, and subgroup analyses compared AD assays to traditional synovial markers such as leukocyte count (LC) and polymorphonuclear percentage (PMN %). <b>Results</b>: A total of 51 studies met inclusion criteria. Reported sensitivity and specificity varied widely across studies, with median values of 0.86 and 0.97 for AD-ELISA and 0.84 and 0.97 for AD-LF. Pooled estimates, derived from studies reporting confidence intervals, demonstrated a sensitivity and specificity of 87.8 % (95 % CI, 81.2 %-94.3 %) and 97.9 % (95 % CI, 96.5 %-99.2 %) for AD-ELISA and of 81.8 % (95 % CI, 76.0 %-87.5 %) and 97.0 % (95 % CI, 95.9 %-98.2 %) for AD-LF, respectively. Compared with traditional synovial leukocyte count and PMN %, both assays demonstrated comparable or superior specificity, particularly for AD-ELISA. Risk of bias was generally low across included studies. <b>Conclusion</b>: Both AD assays demonstrate high specificity in diagnosing PJI, but AD-ELISA offers superior sensitivity compared to AD-LF and traditional synovial markers. Given variability in the underlying diagnostic criteria for PJI, these results should be interpreted within the context of differing reference standards. These findings support the continued use of AD-ELISA as a valid diagnostic modality.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"525-541"},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the efficacy of systemic antibiotics for biofilm-associated infection in an ovine model of simulated fracture-related infection.","authors":"Robert Falconer, David Rothberg, Walker Kay, Connor Hunt, Richard Tyler Epperson, Brooke Kawaguchi, Nicholas Ashton, Dustin Williams","doi":"10.5194/jbji-10-511-2025","DOIUrl":"10.5194/jbji-10-511-2025","url":null,"abstract":"<p><p><b>Introduction</b>: Infection remains a major complication of open fractures, with rates reaching up to 70 % after severe injury. Systemic antibiotics often fail to achieve the therapeutic levels needed to disrupt biofilm at the wound site due to compromised blood flow and systemic dilution. This study investigates the efficacy of systemic antibiotics against <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i> monomicrobial biofilms in an ovine model of simulated fracture-related infection (FRI). <b>Methods</b>: An established model of long-bone FRI in the right hind limb of mature Rambouillet sheep was adapted. Local soft tissue trauma was induced, the periosteum was stripped from the tibial surface, and a simulated fracture was created on the bone surface. The site was inoculated with mature biofilm grown on fracture fixation plates. Sheep were assigned to a treatment group receiving 10 d of systemic antibiotic therapy or a positive control group that received no treatment. All animals were sacrificed at 21 d, and microbiological and histological analysis was performed. <b>Results</b>: Systemic antibiotics failed to produce a statistically significant reduction in <i>S. aureus</i> biofilm compared to the positive control. Systemic therapy significantly reduced <i>P. aeruginosa</i> bioburden compared to the positive control, but levels remained above the clinical threshold for infection. The histological analysis revealed moderate improvement from systemic treatment. <b>Conclusions</b>: This investigation established the limitations of systemic antibiotic therapy in this model of long-bone FRI against <i>S. aureus</i> and <i>P. aeruginosa</i> biofilms. Microbiological and histological analyses revealed hallmark features of recalcitrance to systemic treatment, validating the utility of this model to study anti-infective therapies. These findings highlight the need for new antibiotic delivery strategies to manage biofilm-associated infections.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"511-524"},"PeriodicalIF":2.8,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of the joint-specific bone involvement, antimicrobial options, coverage of the soft tissues, and host status (JS-BACH) classification for predicting the outcome in periprosthetic joint infections following total hip and knee arthroplasties: a promising tool for clinical practice.","authors":"Benjamin Schlossmacher, Vincent Lallinger, Dirk Müller, Rüdiger von Eisenhart-Rothe, Igor Lazic","doi":"10.5194/jbji-10-501-2025","DOIUrl":"10.5194/jbji-10-501-2025","url":null,"abstract":"<p><p><b>Purpose</b>: Periprosthetic joint infection (PJI) represents a major complication of total joint arthroplasty (TJA). The joint-specific bone involvement, antimicrobial options, coverage of the soft tissues, and host status (JS-BACH) classification of 2021 aims to categorize PJI severity and predict PJI recurrence and quality of life following surgical PJI treatment. Until now, only one external validation has confirmed its predictive value for treatment failure. This study aimed to further validate the classification in an external cohort and to compare outcomes between different pathogen groups. <b>Methods</b>: We applied the JS-BACH classification to a cohort of 249 consecutive gram-positive (staphylococci) and gram-negative PJIs in hip and knee joints treated at our institution between 2010 and 2022 (<i>Staphylococcus aureus</i> <math><mrow><mi>n</mi> <mo>=</mo> <mn>62</mn></mrow> </math> ; coagulase-negative staphylococci <math><mrow><mi>n</mi> <mo>=</mo> <mn>115</mn></mrow> </math> ; gram-negative organisms <math><mrow><mi>n</mi> <mo>=</mo> <mn>72</mn></mrow> </math> ). According to the JS-BACH classification, we divided cases into uncomplicated ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>35</mn></mrow> </math> ), complex ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>155</mn></mrow> </math> ), and limited options ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>59</mn></mrow> </math> ). The median (interquartile range, IQR) follow-up was 25.0 (3-59) and at least 12 months. Outcomes were assessed based on the 2013 Delphi consensus on PJI outcome. PJI was defined following the EBJIS classification. <b>Results</b>: A higher JS-BACH category correlated significantly with a lower infection-free survival. Using uncomplicated cases as baseline, the hazards ratio (HR) was 3.2 (95 %-CI 1.3-7.9) for complex and 6.6 (95 %-CI 2.6-16.7) for limited options cases. Similarly, higher JS-BACH categories were associated with lower revision-free survival for recurrent PJI, again with uncomplicated cases as baseline: complex HR 2.2 (95 %-CI 0.9-5.5); limited options HR 4.1 (95 %-CI 1.6-10.8). The mean infection-free survival was 85.7 %, 58.7 %, and 33.9 % for uncomplicated, complex, and limited options cases ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ). <b>Conclusion</b>: The novel JS-BACH classification provides reliable predictions of treatment outcome for the proposed subgroups. It provides a structured and simple-to-use option for classifying PJI in daily clinical practice and for scientific purposes.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"501-509"},"PeriodicalIF":2.8,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluating patient isolation policies for musculoskeletal infections in orthopaedic practice: a scoping review.","authors":"Laura Bessems, Jolien Onsea, Baixing Chen, Marjan Wouthuyzen-Bakker, Irene K Sigmund, Tristan Ferry, Richard Kuehl, Martin Clauss, Alex Soriano, Ricardo Sousa, Annette Schuermans, Willem-Jan Metsemakers","doi":"10.5194/jbji-10-489-2025","DOIUrl":"10.5194/jbji-10-489-2025","url":null,"abstract":"<p><p><b>Introduction</b>: Historically, isolating patients diagnosed with musculoskeletal infections (MSIs) from the general orthopaedic population has been regarded a fundamental aspect of effective infection control. However, this remains controversial. Evolving perspectives on infection prevention, resource constraints, and staffing shortages necessitate a reassessment of current practices. This scoping review examines existing isolation policies for MSIs in orthopaedic practice and provides expert recommendations for hospital policymakers. <b>Materials and methods</b>: A systematic search of seven databases identified 23 320 articles. After deduplication and screening of 10 621 abstracts, 119 full texts were reviewed and 14 studies met the inclusion criteria. A total of 9 studies involved surgical wards, 5 examined general hospital wards, and 2 addressed orthopaedic patients. <b>Results</b>: Evidence indicates that individual isolation measures can reduce methicillin-resistant <i>Staphylococcus aureus</i> infections, whereas additional contact precautions or isolation showed no reduction of transmission risk for extended-spectrum beta-lactamase-producing <i>Enterobacterales</i> in endemic settings. For vancomycin-resistant <i>Enterococcus</i> (VRE), one study found a reduction in infections after implementing individual isolation, while another study reported no impact. No evidence supports separating patients with non-resistant MSIs from elective orthopaedic patients. Similarly, no data support the routine use of dedicated septic wards in orthopaedic practice. <b>Conclusions</b>: Effective infection control relies on hospital-wide strategies, provided that appropriate preventive measures and a high level of compliance with standard precautions are in place. Isolation practices should be selectively tailored to local epidemiology to balance infection prevention with optimal resource utilization. Managing MSIs in specialized centres, instead of dedicated septic wards, may deliver more effective care and adherence to standard precautions.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"489-500"},"PeriodicalIF":2.8,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modular megaprostheses yield high any-type failure rate but acceptable infection control rate in patients with chronic hip and knee periprosthetic joint infection and severe bone loss: a single-center experience.","authors":"Vladislav Bartak, David Jahoda, Michal Benes, Tobias Judl, Matej Mazura, Petr Fulin","doi":"10.5194/jbji-10-479-2025","DOIUrl":"https://doi.org/10.5194/jbji-10-479-2025","url":null,"abstract":"<p><p>Chronic periprosthetic joint infections (PJIs) complicated by severe bone loss are challenging cases that require complex and specialized treatment approaches. Megaprosthetic replacement has gained in popularity in the setting of chronic hip and knee PJI; however, only a limited number of studies reporting on its utility are available. Thus, we aimed to review our cohort of patients with this specific condition who received modular megaprosthesis (MMP) as a limb salvage option in order to assess the failure rates, infection control, and implant longevity. We retrospectively reviewed electronic medical records of 61 patients who received MMPs for chronic hip and knee PJI between 2012 and 2024. The mean follow-up was <math><mrow><mn>6.6</mn> <mo>±</mo> <mn>3.5</mn></mrow> </math>  years. Failures were classified according to the Henderson classification. Kaplan-Meier survival curves were used to assess failure-free, infection-free, and overall implant survival. Cox regression analysis was performed to identify variables associated with MMP failure. Among the 61 patients, 37.7 % experienced any type of MMP failure, with infection recurrence being the most common reason for failure (60.9 %), followed by structural failure of the implant (17.4 %). At the 5-year follow-up, failure-free survival, infection-free survival, and revision-free survival were 65.8 %, 80.0 %, and 70.5 %, respectively. McPherson host grade C was significantly associated with implant failure (hazard ratio (HR) 3.1; 95 % confidence interval 1.4-7.6; <math><mrow><mi>P</mi> <mo>=</mo> <mn>0.024</mn></mrow> </math> ). Conclusively, MMPs represent a valuable treatment option for patients with chronic hip and knee PJI and large bone defects. While infection control is acceptable, the rates of any-type failure are high. These findings should be considered during preoperative patient counseling.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"479-488"},"PeriodicalIF":2.8,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12652866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological profile of prosthetic joint infections in orthopedic oncology: a comparison with conventional joint arthroplasty.","authors":"Joseph J Connolly, Marcos R Gonzalez, Joshua B Davis, Youssef H Moussaoui, Graham S Goh, Antonia F Chen, Adam S Olsen, Santiago A Lozano-Calderón","doi":"10.5194/jbji-10-459-2025","DOIUrl":"10.5194/jbji-10-459-2025","url":null,"abstract":"<p><p><b>Background</b>: Periprosthetic joint infections (PJIs) are a devastating complication following oncologic endoprosthetic reconstruction (EPR). Despite significant efforts to characterize the microbiologic profile of PJI in traditional joint arthroplasty, data are lacking in orthopedic oncology. Our study analyzed the causative microorganisms and time to positivity (TTP) of PJI in oncologic EPR and conventional joint arthroplasty (C-TJA). <b>Methods</b>: We retrospectively compared sample cultures for lower-extremity oncologic EPR and C-TJA patients diagnosed with PJI between 2000 and 2022. All positive microorganisms were assessed, along with clinical and culture method data. Comparisons utilized the Mann-Whitney <math><mi>U</mi></math>  test. <b>Results</b>: We included 70 oncologic EPR and 153 C-TJA patients diagnosed with PJIs. <i>Staphylococcus epidermidis</i> (16.8 % vs. 10.6 %, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.01</mn></mrow> </math> ), <i>Enterococcus</i> spp. (12.6 % vs. 4 %, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ), and <i>Peptostreptococcus</i> spp. (5.3 % vs. 1.3 %, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ) were common and more frequently isolated in oncologic EPR than C-TJA PJI. Conversely, <i>Staphylococcus aureus</i> predominated in samples from C-TJA patients (31.7 % vs. 15.1 %, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ). Differences in endoprosthetic microorganism prevalence were observed between primary versus metastatic bone disease and bone versus soft tissue sarcoma. TTP was highly variable among microorganisms and was significantly faster ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> ) for bone and soft tissue vs. synovial fluid (3 d vs. 4 d) and for broth and solid media vs. broth only (2.5 d vs. 4.5 d). <b>Conclusion</b>: The microorganism profile in oncologic EPR PJI was distinct from C-TJA PJI. The oncologic EPR population highlighted variability in the prevalence of Gram-negative rods and slower TTP for broth-only cultures. Further investigation of the mechanisms behind these differences will allow care teams to provide prompt, individualized, and targeted antimicrobial therapy.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"459-469"},"PeriodicalIF":2.8,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12634182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of the clinical characteristics and outcomes of aerobic and anaerobic prosthetic joint infections (PJIs): a single-center retrospective review.","authors":"Lemuel R Non, Poorani Sekar","doi":"10.5194/jbji-10-471-2025","DOIUrl":"https://doi.org/10.5194/jbji-10-471-2025","url":null,"abstract":"<p><p><b>Background</b>: Prosthetic joint infection (PJI) is an uncommon but serious complication of joint arthroplasty, associated with significant morbidity and healthcare costs. Anaerobic organisms are an under-recognized cause of PJI, either as sole pathogens or within polymicrobial infections, and data on their clinical impact are limited. This study compared clinical presentation and outcomes of anaerobic vs. aerobic PJIs. <b>Methods</b>: This is a retrospective review of 284 patients who met Musculoskeletal Infection Society (MSIS) criteria for PJI from 2014 to 2020 at the University of Iowa Hospitals and Clinics (UIHC). A total of 38 had anaerobic PJI; 268 had aerobic PJI. Statistical analyses were performed using Pearson's <math> <mrow><msup><mi>χ</mi> <mn>2</mn></msup> </mrow> </math> , a Fisher exact test, and a <math><mi>t</mi></math> test. <b>Results</b>: Anaerobic PJIs represented 13.4 % of PJIs in our institution. Compared to aerobic cases, anaerobic PJIs had longer symptom duration (19.4 vs. 10.9 weeks, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.005</mn></mrow> </math> ), more sinus tracts (23.7 % vs. 6.1 %, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ), fewer fevers (13.2 % vs. 31.3 %, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.022</mn></mrow> </math> ), more radiographic abnormalities (44.7 % vs. 29.3 %, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.024</mn></mrow> </math> ), and lower ESR and CRP (ESR: 49.0 vs. 67.4 mm h^-1; CRP: 6.6 vs. 12.3 mg dL^-1; both <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.003</mn></mrow> </math> ). Shoulder PJIs were more often anaerobic (39.5 % vs. 4.9 %, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ). Anaerobic PJIs were more likely to be treated with two-stage exchange (65.8 %), while aerobic cases more often underwent debridement and implant retention (44.7 %). Recurrence rates were similar. <b>Conclusion</b>: Anaerobic PJIs tend to present with features such as shoulder involvement, prolonged or chronic symptoms, sinus tract formation, and radiographic signs of infection, whereas aerobic PJIs are more commonly linked to acute presentations. For this reason, both aerobic and anaerobic cultures should be performed routinely to optimize diagnostic yield.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"471-477"},"PeriodicalIF":2.8,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining postoperative spinal infections: navigating the inconsistencies in diagnostic definitions.","authors":"Seyed Mohammad Amin Alavi, Fabio Borgonovo, Francesco Petri, Takahiro Matsuo, Andrea Gori, Jeremy D Shaw, Aaron J Tande, Elie F Berbari","doi":"10.5194/jbji-10-451-2025","DOIUrl":"10.5194/jbji-10-451-2025","url":null,"abstract":"<p><p>The absence of a standardized definition for postoperative spinal infections (PSIs) hinders both diagnosis and research. Using a meta-epidemiological approach, we analyzed 101 studies, with most relying on predefined criteria but with a minority creating their own definition (mainly clinical). Establishing a universal definition is crucial to enhancing PSI management and facilitating research.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"10 6","pages":"451-457"},"PeriodicalIF":2.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12628270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}